Coverage Terms and Conditions Sample Clauses
The "Coverage Terms and Conditions" clause defines the specific rules, limitations, and requirements that govern the scope of insurance or service coverage under an agreement. It typically outlines what is included or excluded from coverage, any prerequisites for making a claim, and the obligations of both parties to maintain eligibility. For example, it may specify covered events, excluded risks, or necessary documentation for claims. This clause ensures both parties have a clear understanding of the extent and limitations of coverage, thereby reducing disputes and clarifying expectations.
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Coverage Terms and Conditions. Under the coverage terms of the EAP, employees and/or members of their immediate families will each be entitled to unlimited assessment and referral and a maximum of six (6) sessions per problem, at no cost to the employee or family member, for problems amenable to short term counseling intervention. Employees and/or family members are encouraged to access available benefits, as provided by the Employer's medical benefits program, for counseling/treatment beyond the six (6) session limit.
Coverage Terms and Conditions. A. We agree to provide You with specific services for the one (1) Vehicle listed on the Registration Page. These services will include reviewing the Vehicle repair history and, if the Vehicle repair history documents the Vehicle is a Lemon, contracting with attorneys selected by Us to help You pursue a lemon/breach of warranty settlement with, or lawsuit against, the Vehicle manufacturer.
B. If the Vehicle qualifies as a Lemon in the future, We agree to provide You with an attorney or law firm that has experience handling vehicle lemon/breach of warranty claims and to directly pay for all reasonable attorney fees and costs, which will be billed directly to Us. You agree that We have the right to select an attorney or law firm to represent your interests throughout the process of submitting a lemon/breach of warranty claim and filing a lemon/breach of warranty lawsuit on Your behalf. You acknowledge that this Agreement does not allow you to select an attorney or law firm different from the attorney or law firm the Provider chooses.
C. We agree to provide You with reasonable access to Us Monday through Friday (except on national holidays) from 9:00 a.m. until 5:00 p.m. Central Standard Time via telephone or electronic mail to handle your inquiries regarding the Vehicle.
D. Once We objectively determine that the Vehicle qualifies as a Lemon, We will contact an attorney or law firm with specific experience in handling lemon/breach of warranty claims to represent You against the Vehicle manufacturer. The attorney or law firm will then timely contact You to enter a formal attorney-client relationship with You. We are not a party to that attorney-client relationship, but We will be directly responsible for paying the initial attorney fees and reasonable costs for handling your lemon/breach of warranty claim and the filing of a lawsuit if necessary. You will not be responsible for any deductible or copayment of the attorney fees and reasonable costs beyond Your full contractual amount owed as set forth on the Registration Page. We do not make any representations or warranties regarding whether You will be successful in Your claim or lawsuit.
E. You agree to cooperate in all reasonable respects with Us and the attorneys or law firm handling Your claim or lawsuit. This will include providing all relevant information/records and executing sworn affidavits or consents to obtain Vehicle service records.
F. In the event a case is filed in court and is not settled prior ...